Provider Demographics
NPI:1235683533
Name:CARPE DIEM BEHAVIORAL ASSOCIATES, INC.
Entity Type:Organization
Organization Name:CARPE DIEM BEHAVIORAL ASSOCIATES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CARRIER-PELLETIER
Authorized Official - Suffix:
Authorized Official - Credentials:LADC/CCS
Authorized Official - Phone:207-241-7959
Mailing Address - Street 1:1525 LISBON ST
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-3515
Mailing Address - Country:US
Mailing Address - Phone:207-241-7959
Mailing Address - Fax:
Practice Address - Street 1:1525 LISBON ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-3515
Practice Address - Country:US
Practice Address - Phone:207-241-7959
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-04
Last Update Date:2016-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME726134251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health